Provider Demographics
NPI:1215363981
Name:VALRICO SPINE AND REHAB CENTER
Entity Type:Organization
Organization Name:VALRICO SPINE AND REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:R
Authorized Official - Last Name:FABBIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-868-1138
Mailing Address - Street 1:1103 LITHIA PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-6713
Mailing Address - Country:US
Mailing Address - Phone:813-868-1138
Mailing Address - Fax:813-868-1137
Practice Address - Street 1:1103 LITHIA PINECREST RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6713
Practice Address - Country:US
Practice Address - Phone:813-868-1138
Practice Address - Fax:813-868-1137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9904111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty